The purpose of this proposal is to demonstrate the capabilities of the University of Pittsburgh in continuing to participate in the Multicenter Network of Maternal-Fetal Medicine Units. Our unit has been an active participant in the Network for the last nine years. We have demonstrated our willingness to cooperate with other institutions and the NICHD in the development and implementation of clinical research protocols. We have been active participants in all aspects of Network activities. We have proposed protocols, have served on subcommittees of other protocols and have faithfully attended every Network meeting over the last nine years. We have effectively recruited patients for all studies in which we have participated and have provided intellectual input in the development of new projects as well as the implementation of protocols from our center and from others. The data provided by our unit has consistently been of the highest quality based on objective evaluation by the Data Coordinating Center. The Division of Maternal-Fetal Medicine is composed of 16 specialists in Maternal-Fetal Medicine. Each of these individuals has committed in some way to the Network, either in the recruitment of patients or development of protocols. In addition to clinical faculty, there are 7 research nurses committed to the recruitment of patients and acquisition of high quality data for research studies. Eight research faculty in the Division are available to provide specialized expertise for Network projects. The obstetrical unit at the University of Pittsburgh is one of the largest private obstetrical service in the United States with 8700 deliveries annually. In 1994, approximately a third of our patients were considered as high risk prior to labor, including 635 women with preterm labor, 294 with diabetes, 745 women with preeclampsia or hypertension, 611 women with third trimester bleeding, 316 women with cardiac disease, 225 women with severely growth retarded fetuses, and 181 women with multifetal pregnancies. Approximately 2200 women delivering at the University of Pittsburgh are indigent; 1521 are black or Hispanic and 6967 are white, most of which have third party insurance. This wide diversity of patients makes our institution particularly well suited for the performance of clinical trials.